9494 9/11State of New York

Department of Health

To learn more about HIV/AIDS . . . Visit the NYSDOH website at: www.health.ny.gov/diseases/aids.index.Or call the department’s free HIV/AIDS hotline at: 1-800-542-2437.

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Do a self-check of your mouth :

Take some time at least once a month to look inside your mouth for signsof infections and sores. Check your:

• tongue (top and bottom) • lips• gums• cheeks• roof of your mouth

See your doctor if you find:

• white, purple, or red patches• painful sores• bumps• sores that do not heal after 7-10 days

Early treatment can prevent some problems from getting worse. Some ofthese sores can hurt or make eating and drinking uncomfortable. Thesooner your dentist treats you, the sooner you will feel better.

To find a dentist near you . . . In New York State, people with HIV who are uninsured or underinsured canhave their dental care covered by Medicaid, ADAP (AIDS Drug AssistanceProgram), and ADAP Plus. Your case manager can tell you more aboutthese and other programs to help you get free or low-cost care.

Ask your doctor, nurse, social worker, or case manager for the name andphone number of a dentist near you. They may be able to make the ap-pointment for you. The New York State Department of Health (NYSDOH)also has a Dental Resource Directory on its website at: www.health.ny.gov/diseases/aids/resources/dental_resource_directory/index.htm.To order a printed copy of the directory, call (212) 268-6164 or send anemail to HIVPUBS@health.state.ny.us.

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Thrush (candidiasis)Candidiasis is a fungal infection on the inside of your mouth. Candidiasismay look like:

• white patches in your mouth that can be wiped off• a flat red sore that burns, especially when you eat spicy or salty foods• cracks in the skin around the corners of your mouth

Candidiasis can be treated with prescription mouth rinses, pills, orlozenges (pills you suck on instead of swallowing). If thrush is not treated,it can spread down your throat. Then, you may need more complex treat-ment or even hospitalization. Early treatment is best.

Oral hairy leukoplakiaOral hairy leukoplakia:

• looks like white patches that do not wipe off• is usually found along the sides of your tongue• is not painful

Oral hairy leukoplakia usually does not need to be treated. If it becomessevere, your dentist can provide medications and other treatments.

Mouth soresMouth sores include canker sores and cold sores (also called fever blisters).Mouth sores are more common, even in people who do not have HIV. But people with HIV may have larger, more painful sores that take longerto heal. If you have a sore that does not go away in 7-10 days, see your dentist.

To reduce pain from mouth sores:

• avoid acidic foods (like orange juice or tomatoes) • avoid spicy foods (like hot sauce)• ask your dentist about over-the-counter medications

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Oral health care is an important part of your HIV care. “Oral health” means the health of your teeth, gums, and mouth. It affectsthe health of your whole body.

Your body’s immune system helps fight off infections and sickness. HIV, thevirus that causes AIDS, attacks your immune system.

People with HIV have weakened immune systems and are more likely tohave oral health problems. Oral disease can also put more strain on yourimmune system. If you are HIV-positive, tell your dental health careprovider so he or she can give you the best care possible. He or she canwork with your health care providers to make sure you get the treatmentyou need.

Some oral health problems are a sign that your immune system is understress — and that you should see a medical professional. Oral health problems may raise your risk of heart disease, lung disease, and stroke. In pregnant women, oral health problems may raise the risk of having alow birth weight, premature baby.

Some dentists may be prepared to test you for HIV using an oral swab or afinger stick blood test. They can also use a saliva test to find early signs ofsevere periodontal disease and to find HPV (human papillomavirus) andthe potential for other oral cancers. If your dentist does not perform thesetests, ask him or her to refer you to another health care provider for testing. Oral diseases can affect your teeth and gums. They can also affect otherparts of your mouth. Some of the more common oral health diseases are:

• cavities (also called “caries”)• gum disease (periodontal disease)• oral lesions (sores inside your mouth)

Almost everyone has tooth and gum problems at some time in their lives.The most common are cavities and gum disease.

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You can prevent cavities and gum disease Cavities and gum disease can happen to anyone. The good news is thatyou can prevent these problems by following these easy steps:

• See your dentist every 6 months, even if your teeth feel fine. Your dentist can find and fix cavities before they cause you pain and check for gum disease, mouth infections, sores and cancer. So you should go even if you have no teeth.

• Brush your teeth after every meal, or at least 2 times a day. Use fluoride toothpaste and a soft-bristle toothbrush. Change your toothbrush every 3-4 months, or sooner if the bristles look frayed.

• Use dental floss every day. Flossing cleans in between your teeth, where your toothbrush can't reach.

• Use a mouth rinse every day. Ask your dentist if there is a specific mouth rinse you should use.

• Use artificial saliva if you have dry mouth. Dry mouth is a side effect of many HIV medications. Saliva helps keep your teeth clean. So, you are more likely to get cavities if you have dry mouth. You can buy artificial saliva at your local drugstore without a prescription or ask your doctor for some.

Mouth sores and infections People with HIV are more likely to have sores and infections inside theirmouths, including the tongue and lips. Some of these infections are un-common and can only be found by your dentist. Others are more commonand may have symptoms you can see and feel. The most common kinds ofsores and infections that affect people with HIV are:

• thrush (candidiasis) • oral hairy leukoplakia• mouth ulcers (canker sores, cold sores, or fever blisters)

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Cavities Cavities, also called “caries,” are soft spots or small holes in your teeth.

Cavities are caused by plaque, a sticky white coating on your teeth.

Plaque is made up of bacteria (germs) and tiny bits of food left in yourmouth. These bacteria make acid that eats away at your teeth. Good oral health care at home (brushing and flossing regularly) helps prevent cavities by getting rid of plaque.

At first, a cavity is small and does not hurt. If a cavity is not treated with afilling, it can get deeper and become painful. When a cavity is not treated,it can lead to dangerous infections. If the roots of the tooth become infected, you may need a root canal to clean out the roots and save thetooth.

Gum disease Gum disease is an infection of your gums and the bone that holds yourteeth in your mouth. Signs of gum disease are:

• red or swollen gums• gums that bleed when you brush or floss your teeth• gums that are pulling away from your teeth• loose teeth

If gum disease is not treated, your teeth may shift or get so loose that theyneed to be removed. This can even happen to healthy teeth. Early treatment can help you keep your teeth.

People with HIV sometimes have gum disease that gets worse very quickly.All kinds of gum diseases are easier to treat when they first begin. That’swhy it is so important to see your dentist regularly.

Oral health — the health of your teeth, gums, and mouth —affects your whole body.

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